Herpes zoster infection associated with acute coronary syndrome: a population-based retrospective cohort study

[[abstract]]BACKGROUND: Vasculopathy in varicella zoster virus (VZV) infection and a proposed association between herpes virus infection and atherosclerosis suggest a possible link between VZV infection and vascular thrombosis. OBJECTIVES: To determine the risk of acute coronary syndrome (ACS) associated with herpes zoster infection. METHODS: We used the Taiwan National Health Insurance Research Database to identify 57,958 patients newly diagnosed with herpes zoster between 1999 and 2010; 231,832 patients without herpes zoster were examined as the control group. Both cohorts were followed up until the end of 2010 to measure the incidence of ACS. Cox proportional-hazards regression and Kaplan-Meier analyses were used to measure the hazard ratios (HR) and the cumulative incidences of ACS, respectively. RESULTS: The incidence of ACS was 1·24-fold higher in the herpes zoster group than in the control group [36·8 vs. 29·6 per 10,000 person-years, 95% confidence interval (CI) 1·16-1·33]. After adjusting for age, sex and comorbidities, the HR of ACS for the herpes zoster group compared with the control group was 1·15 (95% CI 1·07-1·24). Analysis by the time lag (≤ 3 months, ≤ 1 year, > 1 year) showed that the incidence of ACS remained significantly higher in the herpes zoster group than in the control group, with an adjusted HR of 1·10 (95% CI 1·02-1·19) after the 1-year follow-up period. The Kaplan-Meier survival curve showed that the risk of ACS was significantly higher in the herpes zoster group than in the control group (P < 0·001). CONCLUSION: Herpes zoster infection is associated with an increased risk of ACS. © 2013 British Association of Dermatologists

Palmitic acid in chicken granulosa cell death-lipotoxic mechanisms mediate reproductive inefficacy of breeder hens

In vivo and in vitro approaches were used to elucidate mechanisms of palmitate-induced cytotoxicity of follicle granulosa cells in fuel-overloaded broiler hens. In contrast to their energy-restricted counterparts, broiler breeder hens fed ad libitum for 2 wk had dyslipidemia, atresia within hierarchical ovarian follicles, and a 34% reduction in egg production (P 0.05). Based on vital staining of freshly isolated granulosa cells with annexin V/propidium iodide, there were increases in apoptosis consistent with suppressed Akt activation (P 0.05). Supplementing primary granulosa cell cultures with 0.5 mM palmitate for 48 or 96 h increased apoptosis (P 0.05). Palmitate-induced cell death was accompanied by increased acyl-CoA oxidase, carnitine palmitoyl transferase-1, serine palmitoyl transferase, and sphingomyelinase transcripts and increased concentrations of proinflammatory interleukin-1 (P 0.05). Triacsin-C inhibition of fatty acyl-CoA synthesis blunted interleukin-1 production and rescued granulosa cultures from palmitate-induced cell death. That there was partial to complete prevention of cell death with addition of the free radical scavenger pyrrolidine dithiocarbamate, the sphingomyelinase inhibitor imipramine, or the de novo ceramide synthesis inhibitor fumonisin B1, supported the notion that palmitate-induced granulosa cell cytotoxicity operated through a palmitate-derived metabolite. Palmitoyl-CoA may be channeled into -oxidation and/or into bioactive metabolites that increase free radical generation, an inflammatory response, and ceramide production. In conclusion, palmitate-derived metabolites activated apoptotic machinery in avian granulosa cells, which caused ovarian follicular atresia and reduced egg production in fuel-overloaded broiler breeder hens

“Measuring IT service management performance: a model development

Prompted by the realisation that IT is now seen as a service, with a customer focus and process orientation, the authors propose a model to measure IT service management (ITSM) performance. Measuring ITSM performance will enable organisations to demonstrate the benefit from their investment. The model is based on a systematic literature review that progressed from considering the general areas of organisation performance measurement to examining commonly used performance metrics. Although there are a number of studies on ITSM implementation, only a few considered the performance measurement of ITSM. A structured method for the design of the model was adopted through a three-level analysis. A comparison of existing performance measurement frameworks was first made to identify those that are suitable for ITSM and that would facilitate communication between the business and IT function. This was done using appropriate dimensions from past work of various performance measurement researchers. The frameworks were then classified along these dimensions to identify their completeness, eliminate unnecessary dimensions, and identify the natural dimensions for ITSM